Psychiatric side effects induced by supraphysiological doses of combinations of anabolic steroids correlate to the severity of abuse

Abstract

ObjectiveThe objective of our study was to evaluate the psychological consequences of real-world AAS use in athletes abusing such agents, in comparison with a placebo and control group of comparable athletes, while correlating the severity of abuse with the side effects observed. The hypothesis tested by the study was that the use of AAS induces a wide range of psychological side effects whose impact and emergence is dependent upon the severity of the abuse.DesignThe study includes a substantial group of AAS abusing athletes and two more groups demographically similar to the first, one composed of athletes not using any substance and a placebo group. All athletes were stratified according to the severity of AAS abuse. Psychometric instruments were applied to all athletes in specific time intervals, dependent to the AAS abusers' regimens, providing us with a final psychological profile that was to be compared to the pre-study profile. All results were comparable (within and between groups) for statistically significant differences and correlated to the severity of the abuse. Homogeneity of all groups was safeguarded by random doping controls, monitoring of drug levels and analysis of all self obtained drugs by method of liquid chromatography/mass spectrometry. All athletes were provided with a common exercise and dietary regime, so common training and nutritional conditions were achieved.MethodsWe studied a cohort of 320 body-building, amateur and recreational athletes, of whom 160 were active users of AAS (group C), 80 users administering placebo drugs (group B) and 80 not abusing any substance (Group A). Group C athletes were stratified according to AAS abuse parameters, thus providing us with three subgroups of “light, medium and heavy abuse”. Athletes of groups A and B were included in a “no abuse” subgroup. The psychometric instruments used were the Symptoms Check List-90 (SCL-90) and the Hostility and Direction of Hostility Questionnaire (HDHQ). The psychometric evaluations took place within a time interval of 13 months. Statistical analysis was performed by using the Mann–Whitney/Wilcoxon two-sample non-parametric test (Kruskal–Wallis test for two groups) for data that were not normally distributed and Linear regression analysis was used to ascertain the correlation between severity of use and escalation of side effects.ResultsThe study showed a statistically significant increase in all psychometric subscales recorded in group C, and no statistically significant difference in group C and A. There was a significant increase in the scorings of group C for all subscales of SCL-90 and HDHQ. Correlation of abuse severity and side effects showed that there was a statistical significant increase in Δ values of all SCL-90 and HDHQ subscales that escalated from light abuse to medium and heavy abuse/consumption patterns.ConclusionsThe results of the study suggest that the wide range of psychiatric side effects induced by the use of AAS is correlated to the severity of abuse and the force of these side effects intensifies as the abuse escalates.

Multisubstance Use as a Feature of Addiction to Anabolic-Androgenic Steroids

“…The long-term consequences for the physiology and mental health of individuals combining AAS with all these agents are not easy to foresee. There are a number of reports available in the literature showing that polysubstance use combined with AAS at high doses can result in severe complications [3,8,12,40,41] . The adverse effects of the drugs taken, the interactions associated with polypharmacy, the effects of the large dosages and the increased risk of addiction to other drugs of abuse and alcohol are all major health care concerns that require further study.…”

Aggression questionnaire scores in extremely violent male prisoners, male bodybuilders, and healthy non-violent men

“…However, subgroups of steroid abusers may have known psychiatric pre-morbidities that are likely to introduce bias into the suggested causal relationship between anabolic steroid abuse and neuropsychiatric effects. Studies have also shown a correlation between mental side effects and the severity of steroid abuse [14]. The neural systems underlying the aggression induced by AAS appear to overlap with the brain circuits responsible for the regulation of aggression by endogenous androgens such as vasopressin [15].…”

Anabolic-androgenic Steroid Use in the Nordic Countries: A Meta-analysis and Meta-regression Analysis

“…Moreover, in contrast to current prevalences, lifetime prevalence estimates cannot be validated against objective measures such as urine testing (Pagonis et al, 2006). Although subject to the limitations noted above, our prevalence estimates suggest that non-medical AAS use should be considered a major public health problem in the Nordic countries and must require the attention of policy makers and researchers.…”